The Blog

Lasers and other Light Therapies for Acne

Since 2002 several new light therapies for acne have been under development. Some show promise, but all have drawbacks. The reviews on all are mixed.

Blue Light Therapy

Several studies have shown that low intensity blue light administered a couple of times a week for 10 to 15 minutes may target the p. acnes bacteria, the naturally occurring skin bacteria that proliferates in acne sufferers. The theory is that p. acnes bacteria harbor porphyrins which when exposed to visible light become chemically excited and release an oxygen singlet. Since p. acnes is anaerobic, the oxygen kills it. In clinical trials, the results have been inconclusive.

Originally blue light treatments were performed in a doctor or other practitioner’s office twice a week. Then a model of blue light was developed for home use and the protocol was increased to twice a day. A study published in March 2009 by the Journal of Clinical and Aesthetic Dermatology, The Clinical Efficacy of Self-applied Bluelight for Mild-moderate Acne suggested that overall improvements on average showed a decrease of up to 40% in the number of lesions by day 28 of the treatment.

If you’ve been reading other articles on this site, you already know that targeting p. acnes bacteria is only 1/3 of the acne issue, and not the most important third. So it isn’t too surprising that the results of a therapy that only targets bacteria would only show up to a 40% decrease in lesions. And I don’t know about you, but 2 to 14 hours a month of doing nothing but holding a blue light to my skin doesn’t sound like my idea of time well spent, particularly not for up to a 40% decrease in lesions!

The study also showed that blue light is also not appropriate for individuals with nodulocystic acne (cystic acne) which worsens in the presence of light.

Diode Laser Therapy

It has been noted that a diode laser can shrink or destroy the sebaceous glands which produce the oil that contributes to acne without harming the epidermis. It is by no means pain-free, but it has been shown to work for some individuals, particularly those whose acne is primarily oil driven.

In February of 2004 Dermatologic Surgery published a study of 19 patients with inflammatory acne on their faces who were treated with the 1450-nm diode laser to evaluate the safety and effectiveness of using this laser to treat facial acne. Every patient saw a significant reduction in acne lesions. After one treatment, lesion counts decreased 37%. A 58% decrease was seen after two treatments, and lesion counts decreased by 83% with three treatments. The researchers found that the pain associated with diode-laser treatment is well tolerated with a topical anesthetic. Side effects in this study were limited to temporary redness and swelling at the treatment sites.

The study sited here was very small. Most “treatment” studies are, as it is hard to fund them. The FDA has different rules for accepting treatments as opposed to drugs and there isn’t one manufacturer that stands to profit significantly from a treatment protocol, so there isn’t a wealthy source willing to pay for large studies. Because the studies are small, they aren’t statistically significant, which means the results might not bear out for a larger population.

Yet even if they held true, the results may not be as impressive as they sound. If you started with 50 blemishes, you would still have eight or nine when the treatment was complete. What happens next? The study does not imply that improvement continues or how long the achieved improvement was maintained. We know from the experience of Accutane, which also works by cutting sebaceous production, that for many, over time the blemishes return. Stopping sebum does nothing to halt the shedding of excess skin cells, so you haven’t eliminated the cause of acne.

A quick survey of review sites reveals that many patients are not satisfied with laser treatments they receive for acne. Typically laser treatments are expensive and the long term side effects are not yet known.

IPL Therapy

A combination of intense pulsed light and heat energy has been shown to both reduce the size and productivity of the sebaceous gland, and target the p. acnes bacteria. A small study in Israel in 2002 as reported in Journal of Cosmetic and Laser Therapy (June 2004) showed nearly 90% of the 19 participants had some reduction of lesions after undergoing twice a week treatments for four weeks and then follow up visits one and two months after treatment was completed. No significant side effects were reported.

Again, the study is very small, and “some reduction of lesions” sets the bar pretty low in the battle against acne.

So there are new high-tech treatments for acne out there, but to date none have proven as successful as the protocol used at The Acne Treatment Center, and they are certainly more expensive